Cricothyrotomy Surgical

From Protocopedia
Jump to navigation Jump to search
The printable version is no longer supported and may have rendering errors. Please update your browser bookmarks and please use the default browser print function instead.

Procedure Guidelines 9.10

CRICOTHYROTOMY (SURGICAL)

INDICATIONS:

  • If unable to ventilate and airway not patent, perform Cricothyrotomy, as listed on line 5, page 2-7 in the Practice Parameters.
  • When an airway is needed and intubation is unsuccessful.


CONTRAINDICATIONS:

  • Children under 12 years old.
  • Known bleeding disorder and/or anticoagulant therapy.
  • Unable to locate landmarks.


EQUIPMENT:

  • #11 scalpel blade with handle.
  • Needle nose hemostats.
  • 5.0 to 7.0 mm endotracheal tube, cut above pilot balloon.
  • Antiseptic swabs.
  • Tape.
  • BVM.


PROCEDURE: (refer to illustrations):

  • Place the patient in a supine position with the neck in a neutral position.
  • Palpate the thyroid notch, cricothyroid membrane, and the sternal notch for orientation. Gather equipment.
  • Prepare site with Antiseptic swabs.
  • Stabilize the thyroid cartilage with thumb and 3rd finger of hand. Stretch skin taut.
  • Make a superficial transverse skin incision over the cricothyroid membrane. Carefully puncture through the membrane and maintain site with tip of gloved index finger.
  • Insert the scalpel handle into the incision and rotate 90 degrees to open airway OR insert hemostats to enlarge opening for passage of tube.
  • Insert cuffed endotracheal tube into the cricothyroid membrane incision directing the tube distally into the trachea.
  • Inflate the cuff and ventilate the patient with BVM.
  • Observe breath sounds and auscultate the chest for adequate ventilation.
  • Secure the endotracheal tube.
  • Continue to ventilate and observe chest rise.